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423. Kampf G, et al. Influence of applied volume on efficacy of 3-minute surgical reference disinfection method prEN 12791. Applied Environmental Microbiology, 2004,70:7066-7069. 424. Kampf G, et al. Suitability of Sterillium gel for surgical hand disinfection. Journal of Hospital Infection, 2003, 54:222-225. 425. Greer RB, 3rd. The ritual at the scrub sink. Orthopaedic Review, 1994, 23:97. 426. Larson E et al. Prevalence and correlates of skin damage on the hands of nurses. Heart & Lung, 1997, 26:404-412. 427. Tupker RA. Detergent and cleansers. In: van der Valk PGMM, HI ed. The irritant contact dermatitis syndrome. New York, CRC Press, 1996:71-76. 428. Graham M et al. Low rates of cutaneous adverse reactions to alcohol-based hand hygiene solution during prolonged use in a large teaching hospital. Antimicrobial Agents and Chemotherapy, 2005, 49:4404-4405. 429. Wilhelm K-P. Prevention of surfactant-induced irritant contact dermatitis. In: Elsner P, Lachapelle JM, Wahlberg JE, Maibach HI, eds. Prevention of contact dermatitis. Current problems in dermatology. Basel, Karger, 1996:78-85. 430. Kownatzki E. Hand hygiene and skin health. Journal of Hospital Infection, 2003, 55:239-245. 431. de Haan P et al. Irritancy of alcohols. In: van der Valk PGM, Maibach HI, eds. The irritant contact dermatitis syndrome. New York, CRC Press, 1996: 65-70. 432. Lubbe J et al. Irritancy of the skin disinfectant n-propanol. Contact Dermatitis, 2001, 45:226-231. 433. Ohlenschlaeger J et al. Temperature dependency of skin susceptibility to water and detergents. Acta Dermato-venereologica, 1996, 76:274-276. 434. Emilson A, Lindbert M, Forslind B. The temperature effect of in vitro penetration of sodium lauryl sulfate and nickel chloride through human skin. Acta Dermato-venereologica, 1993, 73:203-207. 435. De Groot AC. Contact allergy to cosmetics: causative ingredients. Contact Dermatitis, 1987, 17:26-34. 436. Schnuch A et al. Contact allergies in healthcare workers - results from the IVDK. Acta Dermato-venereologica, 1998, 78:358-363. 437. Rastogi SC et al. Fragrance chemicals in domestic and occupational products. Contact Dermatitis, 2001, 45:221-225. 438. Uter W et al. Association between occupation and contact allergy to the fragrance mix: a multifactorial analysis of national surveillance data. Occupational and Environmental Medicine, 2001, 58:392-398. 439. Perrenoud D et al. Frequency of sensitization to 13 common preservatives in Switzerland. Swiss contact dermatitis research group. Contact Dermatitis, 1994, 30:276-279. 440. Kiec-Swierczynska M et al. Occupational skin diseases among the nurses in the region of lodz. Internal Journal of Occupational Medicine and Environmental Health, 2000, 13:179-184. 441. Garvey LH et al. Anaphylactic reactions in anaesthetised patients - four cases of chlorhexidine allergy. Acta Anaesthesiologica Scandinavica, 2001, 45:1290-1294. 442. Pham NH et al. Anaphylaxis to chlorhexidine. Case report. Implication of immunoglobulin E antibodies and identification of an allergenic determinant. Clinical and Experimental Allergy, 2000, 30:1001-1007. 443. Nishioka K et al. The results of ingredient patch testing in contact dermatitis elicited by povidone-iodine preparations. Contact Dermatitis, 2000, 42:90-94. 444. Wong CSM et al. Allergic contact dermatitis from triclosan in antibacterial handwashes. Contact Dermatitis, 2001, 45:307. 445. Scott D et al. An evaluation of the user acceptability of chlorhexidine handwash formulations. Journal of Hospital Infection, 1991, 18:51-55. 446. Kanzaki T et al. Occupational allergic contact dermatitis from ethyl-2-bromo-p-methoxyphenylacetate. Contact Dermatitis, 1992, 26:204-205. 447. Patruno C et al. Allergic contact dermatitis due to ethyl alcohol. Contact Dermatitis, 1994, 31:124. 448. Okazawa H et al. Allergic contact dermatitis due to ethyl alcohol. Contact Dermatitis, 1998, 38:233.
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The WHO Guidelines on Hand Hygiene
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CONTENTS INTRODUCTION . ...........
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17. Organizing an education program
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INTRODUCTION The WHO Advanced Draft
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Handwashing. Washing hands with pla
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still considered the standard of ca
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treatment selectively removes glyce
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of the organism on their hands. Mak
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6. MODELS OF HAND TRANSMISSION 6.1
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In the 1960s, a prospective, contro
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for its ability to reduce the relea
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8.2 SHORTCOMINGS OF TRADITIONAL TES
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tions of short-chain aliphatic alco
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9.1.3 WATER QUALITY The physical, c
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Case study: experience of Egypt The
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and both reduced viral counts on ha
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activity of chlorhexidine is not se
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protein synthesis and alteration of
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in micelle structures formed by sur
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In all the studies that included pl
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isopropyl alcohol) were applied to
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3) Glycerol is added using a measur
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in 2005 the costs of an alcohol-bas
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infection, risk factors that are la
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11.4.4 SIDE-EFFECTS OF THE SURGICAL
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• Repeat the process on the other
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12.2 ALLERGIC CONTACT DERMATITIS RE
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particularly when resources are lim
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Handrubs are available as gels, sol
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14. HAND HYGIENE PRACTICES AMONG HE
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quantified in observational studies
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According to behavioural theories (
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of water with special leaves) outsi
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Furthermore, according to Phra Depv
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16. BEHAVIOURAL CONSIDERATIONS 16.1
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and community factors must be consi
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i. ii. iii. iv. v. vi. a) b) Educat
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tion precautions 580 . There are al
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follow the intent 588 . Studies hav
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18. FORMULATING STRATEGIES FOR HAND
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18.2 DEVELOPING A STRATEGY FOR GUID
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1998 (P
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HCWs routinely to wear vinyl gloves
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quality gloves, reuse, shortage of
Page 94 and 95: • To test for holes, gloves shoul
Page 96 and 97: Figure l.20.2: Blood safety: crucia
Page 98 and 99: Consensus recommendations are that
Page 100 and 101: D. Wash hands with either plain or
Page 102 and 103: 5. SKIN CARE A. B. C. Include infor
Page 107 and 108: PART III. OUTCOME MEASUREMENTS 1. M
Page 109 and 110: 2. HAND HYGIENE AS A QUALITY INDICA
Page 111 and 112: can be seen during routine work. Da
Page 113 and 114: Case study: United Kingdom national
Page 115 and 116: PART IV. PROMOTING HAND HYGIENE ON
Page 117 and 118: ated to reinforce its principles (t
Page 119: 6. PRINCIPLES OF COUNTRYWIDE HAND H
Page 122 and 123: As many international and national
Page 124: debate that resulted in increasing
Page 128 and 129: 23. Lee YL et al. Colonization by S
Page 130 and 131: Interscience Conference on Antimicr
Page 132 and 133: 122. Vicca AF. Nursing staff worklo
Page 134 and 135: 171. Kauppinen J et al. Hospital wa
Page 136 and 137: 224. Krilov LR et al. Inactivation
Page 138 and 139: 276. Thomas L et al. Development of
Page 140 and 141: 326. Johnson S et al. Prospective,
Page 142 and 143: 34th Interscience Conference on Ant
Page 146 and 147: 474. West DP et al. Evaluation of a
Page 148 and 149: 524. Muto C et al. Hand hygiene rat
Page 150 and 151: 578. Babcock HM et al. An education
Page 152 and 153: Interscience Conference on Antimicr
Page 154 and 155: 679. Hirschmann H et al. The influe
Page 156: 729. Martin LS, McDougal JS, Loskos
Page 161 and 162: Table I.8.1: Basic experimental des
Page 163 and 164: Table I.9.1: Waterborne pathogens a
Page 165 and 166: Table I.9.3: Virucidal activity of
Page 167 and 168: Table I.9.4: Studies comparing the
Page 169 and 170: Table I.9.6: Studies comparing the
Page 171 and 172: Table I.14.1: Hand hygiene frequenc
Page 173 and 174: Table I.14.2: Hand hygiene adherenc
Page 175 and 176: Table I.15.1: Hand hygiene indicati
Page 177 and 178: Table I.18.1: Strategies for succes
Page 179 and 180: Table l.20.1: Possible problems and
Page 181 and 182: Table I.21.1. Hand hygiene research
Page 183 and 184: Table I.21.1: Hand hygiene research
Page 185 and 186: Table I.21.2: Unsolved issues for r
Page 187 and 188: Table III.2.1: Quality indicators r
Page 189 and 190: Table V.3.1: Examples of public inf
Page 191 and 192: Table V.4.1: Examples of national p
Page 193: Table V.5.1: The public information
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APPENDIX 1. DEFINITIONS OF HEALTH-C
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APPENDIX 2. HAND AND SKIN SELF-ASSE
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Data in coloured cells can be chang
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NHS NICU n-P NPSA NA NS OPD PACU PA
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AUTHORS: John Boyce Saint Raphael H
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Garance Upham People’s Health Mov
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